An apple a day keeps the doctor away

The Hadassah University Medical Center’s annual Women’s Health Day attracted crowds who wanted to learn how to live better and longer.

May 25, 2013 22:22
Hadassah’s Women’s Health Day at the Israel Museum a jazz band played.

Hadassah womens health day 370. (photo credit: JUDY SIEGEL-Itzkovich)

Although less than two percent of national health expenditures go to education, promotion and prevention of disease, this doesn’t reflect a lack of interest among the public. At a recent Women’s Health Day organized for the 11th time at Jerusalem’s Israel Museum by Hadassah University Medical Center’s Patricia and Russell Fleischman Women’s Health Center, 2,000 people attended, and some even tried to use their voices and elbows to get into the packed auditoriums.

Inside, professors of gerontology and gynecology, a senior clinical dietitian and other professionals from Hadassah’s two Jerusalem medical centers and others lectured while a jazz band played outdoors during the breaks.

“Every woman has a circle of influence on health – that of their family and the community,” said Prof. Neri Laufer, retired chief of Hadassah’s obstetrics and gynecology branch and now director of its Women’s Community Health Center. We decided 13 years ago to launch a project not for treating disease but to prevent it and promote the health of women in the community.

Now we have centers in Beit Shemesh, Abu Ghosh and the Jerusalem neighborhoods of Gilo and the Katamonim. We have 120 volunteers in the project.”

Although most of the free lectures focused on women in middle and old age and how to preserve one’s physical and mental health, they were attended by women of all ages – and some men.

Dorit Adler, Hadassah-Ein Kerem’s chief clinical dietitian, spoke on “Healthy Nutrition for Quality Memory.”

No society, she said, will be able to afford treatment for all diseases connected to aging. Thus societies will have to prevent them. There are dozens of things that affect the functioning of body and brain and hundreds more that we don’t know about.

What we eat can have beneficial or damaging effects.”

Adler noted that the brain uses 16 times more calories than muscle tissue and that the brain’s metabolism is a fifth to a quarter of all our energy expenditures. Without food, the brain reduces its investment of energy in memory so it can protect life.

When in physical danger, the body has more urgent concerns. Thus, a short- or long-term lack of food affects both our bodies and our minds.

The Hadassah dietitian said that sugar added to the diet (beyond sugar found naturally in foods as in fruits) has a major role in overeating, poor memory formation, learning disorders and depression. Blood vessels supply oxygen and nutrients to the brain when the arteries remain clean and function normally. This, she said, improves memory. An influential study conducted by Prof. Iris Shai at Beersheba’s Ben-Gurion University of the Negev studied the effects of a controlled diet over two years observed by employees in Dimona’s nuclear plant.

There are no kiosks there, only one large dining room used by all. Shai studied overweight people and divided them into three groups; one group was fed a low-carbohydrate diet (including sugars), another a low-fat diet and the third a Mediterranean diet of vegetables and fruit, olive oil, pulses, nuts, fish, lean poultry, a minimum of red meat and reduced salt. They were also asked to observe the same diets at home and elsewhere.

At the end of the study, all three groups were found to have lost significant weight and lowered their blood pressure – but those who followed the Mediterranean diet did the best. A subsequent study at Hadassah under similar conditions found that people who lost only five kilos in two years and had fatty plaques in their carotid artery to the brain had much less of a blockage.

The diet actually cleaned up the blood vessels and repaired them.

Other diet studies conducted abroad reduced participants’ butter and salt content, added nuts and olive oil and found that death rates from heart disease and hypertension declined significantly, Adler related. The people of China have among the highest rates of diabetes and complications, explained Adler, because multinational fast-food companies opened branches there, and people now take the car instead of biking.

There is now a proven recipe for better physical and mental health and longer life, she continued. Those who change their lifestyle, exercise regularly and lower their weight and salt and alcohol consumption can reduce the risk of stroke and cardiovascular disease by 60 percent.

“And there are ways of reducing the risk of dementia,” said Adler. “A Mediterranean diet, which is much kinder to a sustainable Earth and does not erode the ability to grow food, is good for reducing the risk of cognitive harm. It can lower the danger of mild cognitive impairment [MCI] converting into fully fledged Alzheimer’s disease. The time has come to connect what we put on our plate with whether we will be healthy or not.”

Among the worst foods often consumed in Israel are burekas, malawah and other foods with trans-fats and white flour, as well as sweet drinks. Just one can of soft drink a day significantly increases the risk of diabetes. Sugar is absorbed quickly into the bloodstream. Avoid white flour and prefer full-grained bread, rice, pasta and couscous.

Don’t use margarine. Eat healthy fats like those in avocado, nuts, olive and canola oil. If you buy sweets and other foods with empty calories “just for the kids” or the grandchildren, you will have an excuse to eat them or will teach them bad habits. Don’t buy them at all, Adler advised.

Adler presented a graphic “triangle” developed by Hadassah nutrition and metabolism expert Prof. Elliot Berry that includes lifestyle and not only what you eat. Berry endorses having family meals (the stuff that pleasant memories are made of); drinking a lot of water; exercising; inviting friends to eat healthful meals together; drinking herbal or other teas and even coffee; consuming whole grains, olive oil, sweet potatoes, garlic, onion, low-fat dairy products, eggs (if there is no cholesterol problem) and pulses daily; and minimizing red meat, cookies, cakes and candy.

“Superfoods” include wild salmon, blueberries and pomegranates, according to Berry.

Adler added that skipping breakfast is a nutritional sin.

“Breakfast is breaking your fast after your nightly sleep. There is little glycogen – a polysaccharide made and stored mostly in the cells of the liver and the muscles that functions as as the secondary long-term energy storage site in the human body,” said Adler. The nutritionist warned that skipping breakfast has been shown to harm the ability to remember words or tell a story – a clear problem for schoolchildren and students. “It is advisable that everybody must eat a nutritious breakfast before leaving home in the morning,” she said.

Up to four cups of coffee a day – without sugar – can help reduce the risk of dementia, according to animal studies that apparently are relevant to humans as well. A lack of iron and vitamin B12 can harm memory, but supplements should be taken only after consulting a doctor, Adler asserted. Most people think that taking vitamins and other supplements “will help or at least won’t hurt” health. But the nutritionist said this is not true. There are cases in which taking them can cause actual harm, she said.

“There are serious, independent studies on vitamins and lung cancer in smokers that showed beta carotene not only did not reduce rates of this cancer but even increased death rates from it. Some nutrients are helpful only if consumed from food and not taken in pill form.”

Ginkgo biloba, for example, remains a very popular supplement sold in health food stores and pharmacies that was believed to improve memory and lower the risk for dementia, said Adler.

“But only a month ago, the US Food and Drug Administration issued a warning that gingko may be carcinogenic, causing liver or thyroid cancer, and hemorrhaging of the brain. So don’t believe the ads and don’t take supplements without consulting an expert.”

Cinnamon, however, helps balance blood sugar and improves attention, memory and visual motor ability. There is much evidence that drinking over two cups a day of unsweetened tea – especially the green type – can lower the risk of age-related memory decline by over 50%. The overconsumption of alcohol – more than two glasses of wine daily or their equivalent – can cause memory problems, Adler continued. “If you have to consume alcohol, do so only with food. Women can take much less safely than men, as it can increase the risk of breast cancer.”

PROF. ZEEV Meiner of the geriatric neurology clinic in the neurology department of Hadassah-Mount Scopus also lectured about memory problems.

“Aging normally causes harm to memory.

Our brain matures at age 18, and by the time we reach 30, the number of nerve cells in the brain – which cannot replicate – begins to decline. The weight of the brain in old age drops by 30% from what it was at 30. There are fewer synapses between neurons, and amyloid plaques develop, allowing less blood flow. We are born with billions of neurons; they die, and nothing can bring them back.”

Humans live up to the age of 120, not only biblically. Only the tortoise lives longer, to about 150 years. People over the age of 85 are the fastest-growing group in the population.

When spaces develop in the hippocampus in the temporal part of the brain, immediate recall, word fluency and verbal meaning, both long- and short-term memory decline. This is normal, said Meiner.

“However, as people get older, communications, understanding and vocabulary increase because we have a lot of life experience that can cover for the deficits. Yet when a person develops dementia, his ability to cover up for the cognitive losses is reduced.”

Mild cognitive impairment (MCI) may occur over the age of 50.

“There’s a subjective feeling of less memory, but people can function very well.

there is no pill to prevent it. But there is a risk of an annual 10% memory decline towards dementia. Theoretically if people eat 30% to 50% fewer calories, their mental abilities would improve, but who can do that,” the gerontologist continued.

“There is much evidence that regular physical activity can improve memory.

Use it or lose it. A lifelong study of nuns in a Kentucky convent found that those who had good mental and intellectual activity at 16 suffered less dementia when they reached old age.”

Among the brain-stimulating activities Meiner mentioned were crossword puzzles, Sudoku and cards, going to museums, playing music or computer games. Find what you like and do it on an ongoing basis.

In addition, depression reduces memory.

You need a positive attitude. Go out and see people, he continued.

“Dementia is a very difficult disease, which we treat in our clinic. A person loses his independence, develops lower functioning and has to be cared for. He can’t be left alone. Alzheimer’s is the main cause of dementia, but there are others, including depression, drugs, alcohol, liver and kidney disease, benign brain tumors and reduced blood flow. Some can be treated.

But Alzheimer’s is irreversible.”

There are four million Alzheimer’s sufferers in the US and 100,000 in Israel.

Meiner praised the activity of the voluntary organization Melabev, the EMDA organization and others that help victims and their families.

“It is very hard for families and caregivers especially. They are frustrated by constant repetition of questions. Patients can get lost even in familiar surroundings and suffer personality changes,” said Meiner. The changes in the brain can be viewed in CT, MRI and PET scans, but they are best viewed after death, from a biopsy of the brain.

“We hope that one day there will be drugs to slow the development of Alzheimer’s, prevent and even cure [it],” Meiner concluded.

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